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Órgano oficial de la Universidad Autónoma de Sinaloa

2025, Number 2

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Rev Med UAS 2025; 15 (2)

Predictive value of the Graf Scale for diagnosing developmental dysplasia of the hip in infants aged 1 to 6 months

Ibarra-Zavala AC, López-Valladares A, Castellanos-Villalobos ML, Angheven-Espinoza I, Torres-Hernández RM

Language: Spanish
References: 17
Page: 66-72
PDF size: 181.69 Kb.


ABSTRACT

Objective: To evaluate the predictive value of the Graf classification system for the early diagnosis of developmental dysplasia of the hip in infants aged 1 to 6 months using hip ultrasound (US). Materials and Methods: An observational, analytical, and retrospective study was conducted by reviewing medical records of patients diagnosed with DDH. Data on α and β angles from US reports were collected. Measurements included angles formed by Hilgenreiner and Perkins lines, as well as the congruence of Shenton's line. Results: A total of 127 clinical records were reviewed, with patients averaging 4.45 ± 1.94 months of age. Hip US showed normal α and β angles (greater than 60° and less than 55°, respectively) in 9 patients (3 females and 6 males), and abnormal angles in 118 patients (76 females and 42 males). The test showed a specificity of 66% (0.66), sensitivity of 97% (0.97), positive predictive value of 97% (0.97), and negative predictive value of 75% (0.75). Conclusions: Hip US demonstrates a high positive predictive value as a diagnostic tool for DDH, though its negative predictive value is relatively lower.


REFERENCES

  1. Bracken J, Tran T, Ditchfield M. Developmentaldysplasia of the hip: controversiesand current concepts. J Paediatr ChildHealth. 2012 48(11):963-72

  2. Tian-tian Dong, Fang Nie, Lu-lu Yang. Ultrasonographyin the evaluation of various factorsof developmental dysplasia of the hip ininfants: Results from a retrospective study ina large hospital of northwest China. J OrthopSci. 2024;29:976-982.

  3. Nicholson A, Dunne K, Taaffe S, Sheikh Y,Murphy J. Developmental dysplasia of thehip in infants and children. BMJ.2023:383:e074507

  4. Claro HJC, Mora RFG, Mejía RC, GarcíaRV.F, Hernández LO. Epidemiología de ladisplasia del desarrollo de la cadera. RevEsp Méd Quir. 2017;22(2):22-27.

  5. Mendoza MGA, Proaño MLF, Villota MBA,Miranda BLA, Arias FJD, Padilla TDG. Displasiade cadera en el desarrollo. RevOcronos. 2024;7(7):694.

  6. Kenanidis E, Gkekas NK, Karasmani A GeneticPredisposition to Developmental Dysplasiaof the Hip. J Arthroplasty.2020:30:291-300

  7. Moraleda L, Albiñana J, Salcedo M. GonzalezM. Displasia del desarrollo de la cadera;Unidad de Traumatología y Ortopedia Infantil,Servicio de Cirugía Ortopédica y Traumatología,Hospital Universitario La Paz,Madrid, España; Rev Esp Cir Ortop Traumatol.2013; 57(1):67-77.

  8. Isunza RA, Isunza-Alonso OD. Displasia dela cadera. Acta Pediatr Méx 2015;36(3):205-207.

  9. Lussier EC, Sun YT, Chen HW, Chang TY,Chang CH, Ultrasound screening for developmentaldysplasia of the hip after 4 weeksincreases exam accuracy and decreases follow-up visits Pediatr Neonatol, 2017;36:239-251.

  10. Holen KJ, Tegnander A, Bredland T, JohansenOJ, Saether OD, Eik-Nes SH. Universalor selective screening of the neonatal hip usingultrasound? A prospective, randomisedtrial of 15,529 newborn infants. J Bone JointSurg Br. 2002:84(6):886-90.

  11. Gahleitner M, Pisecky L, Gotterbarm T,Högler W, Luger M, Klotz MC. Long-term Resultsof Developmental Hip Dysplasia UnderTherapy With Pavlik Harness. J Pediatr Orthop.2024;44(3):135-140.

  12. Cooper AP, Doddabasappa SN, Mulpuri K.Evidence-based management of developmentaldysplasia of the hip. Orthop ClinNorth Am. 2014;45(3):341-54.

  13. Starr V, Yoon BH. Imaging Update on DevelopmentalDysplasia of the Hip With the Roleof MRI. AJR Am J Roentgenol.2014;203(6):1324-35.

  14. Villanueva MS, Hermida OEH, Benavides-RD, Hermida OJ Aplicación del método deGraf para el diagnóstico y tratamiento oportunode displasia de cadera. Acta OrtopMex. 2022; 36: 2-7.

  15. Geertsema D, Meinardi JE, Kempink DRJ,Fiocco M, van de Sande MAJ. Screeningprogram for neonates at risk for developmentaldysplasia of the hip: comparing firstradiographic evaluation at five months withthe standard twelve week ultrasound. A prospectivecross-sectional cohort study. Int Orthop2019;43:1933–1938.

  16. Gümüştaş SA, Orak MM, Onay T, Bulut G.Late. Developmental Dysplasia of the HipThat Was Sonographically Determined to BeStable at First Examination: A Case Report.JBJS Case Connect. 2013 13;3(4 Suppl3):e114.

  17. Paton RW. Screening in DevelopmentalDysplasia of the Hip (DDH). Surgeon.2017;15(5):290-296.




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